An Assessment of Twelve Cases of HELLP Syndrome Treated at the King Fahad Central Hospital, Gizan, Saudi Arabia

Abstract

A total of 11,051 deliveries were conducted during period spanning four years, from July 1993 to June 1997. Twelve patients presented with the HELLP syndrome, a high incidence of 1.0 per 1000 deliveries. A significant proportion (75.0 per cent) of these women was multiparous with a mean age of 27.6 years, and majority (83.3 per cent) had preterm deliveries. Prominent presenting clinical features included preeclampsia (proteinuria and hypertension), eclampsia, jaundice, epigastric pain, anorexia and malaise. Relevant laboratory profiles on all patients met the criteria for confirmation of the diagnosis of HELLP syndrome. Important complications were disseminated intravascular coagulation, acute renal failure, transient cortical loss of vision, pulmonary oedema and transient nephrogenic diabetes insipidus. All patients required supportive care in the hospital's intensive care unit at the peak of their illnesses, and essential treatment consisted of control of fits and hypertension, transfusion of blood, fresh frozen plasma and albumin. Although, fortunately, there was no maternal death in spite of the severe and often stormy maternal morbidity, a very high perinatal mortality rate of 308 per 1000 was recorded. (Afr J Reprod Health 1999; 3 [2]: 68-78)


Key Words: HELLP syndrome, King Fahad Central Hospital, pre-eclampsia-eclampsia